Monday, April 17, 2006

Educating Doctors: Across the country, state attorney general's offices are distributing educational grants to educate doctors and nurses about drug company sales tactics. There's money in Vermont, Massachusetts, Oregon, Kentucky, Ohio, and Illinois, to name a few.

The money for the grants is part of settlement reached by several states with the makers of Neurontin, a drug used to treat painful nerve damage that was pushed off-label for psychiatric illnesses. Over the next two years, they expect to give away $9 million in grants, and ultimately $20 million.

The medical school will use its $398,704 to improve curriculum for medical and pharmacy students, as well as train faculty who are practicing physicians and pharmacists. Clint Snyder, NEOUCOM's associate dean for health profession education, said the training focus will be on how drugs are approved by the Food and Drug Administration and how to find evidence-based research on a drug.

Much of the new training will teach doctors and residents how to handle sales pitches from drug company representatives who visit hospitals and doctors' offices to promote medications.

``One of the things we're going to try to teach our students,'' Snyder said, ``is that what you see in academic, peer-reviewed journals is a more reliable source of information than the information from the person whose job it is to sell that drug.

``They need to understand that the makers of drug X will have information that makes drug X look good.''

In Vermont, they plan to have actors play sales reps so students can role-play being detailed by reps.

Just one question. Aren't medical students being trained to critically evaluate information already? Guess not. Sigh.

4 Comments:

30+ years ago I took a class taught by a drug wholesale sales manager as part of my business program. I find it very troubling that doctors are not aware of the sales techniques of the drug reps, especially given their big play in various business periodicals. Equally troubling is that doctors are so easily taken in by a practiced sales pitch that can be timed down to as little as 15 seconds.

Ah, yes, Neurontin and Warner-Lambert, which is now part of Pfizer. The fraudulent marketing of this drug holds the dubious distinction of generating the largest fine ever levied by the FDA on a drug company - $430 million. And the multi-prong campaign aimed at doctors showed just how aggressive one drug company can be promoting just one drug. Read about it from the FDA itself: http://www.fda.gov/fdac/features/2004/404_wl.html .

One has to wonder how often other drugs are marketed in a similar fashion.

Teaching doctors to get most of their information from journals instead of sales reps is a good start, but they should also be taught how to evaluate those studies. The vast majority of drug studies are sponsored and controlled by the people who want to sell the drug. Negative information is suppressed, and the results are accordingly skewed.

Doctors have to understand that drug companies are run by salesman. These are the true believers who can look you in the eye and state the drug they are selling that day is the drug that is right for every patient.

Under served is code for not meeting sales expectations. You can bet that if an under served population is found the "standards" of treatment will change to create a larger group of customers.

In the late 1980s I heard a doctor rant that we did not understand the benefits of the pharmaceutical industry and that mandated treatment should be the standard. I laughed.

At my last dental visit my dentist wanted to know what was going on with my health since I am not taking any medications. All of his insured patients over 30 were taking a statin, thyroid medication, and multiple BP meds. That doctor and big pharma got what it wanted, everyone taking something, but can we afford the price?